冠心病的左室形态与功能多变量分析

Analysis of multiple variables on left ventricular function and spatial geometry of coronary heart disease

作者应用二维超声多普勒技术，以经胸壁与经食管两种检测方法，对心肌梗塞、心肌缺血及正常人３组共１００例进行左心室形态构型与机能的研究。检测１６项参数，进行组间对比，对左室每搏量进行多元回归分析，并且应用敏感参数进行判别分析。结果发现：冠心病尤其是心肌梗塞主要的左室形态改变是中部环径增大，使左室由锥体形向球体形转化；主要的功能改变是射血分数降低及泵血时左室工作方式的改变：由正常时的中部环向收缩及长径轴向收缩为主变为底部环向收缩为主。多元回归分析表明乳头肌水平环径对于左室每搏量及容积均为重要参数；在两个临界水平建立的判别函数有较大的实用价值。

A study on left ventricular function and spatial geometry was performed in 100 cases of myocardial infarction , ischemia and normal people by means of two dimentional color Doppler echocardiography through thorax and through esophagus. Sixteen parameters were detected and compared among the 3 groups. Multiple variable regression analysis for LV volume and SV and multiple variable discriminant analysis according the significant parameters were performed. The results demonstrated that in coronary disease, especially in myocardial infarction, the main change of left ventricular spatial geometry was the increase of middle LV ring and it would change left ventricle from its cone shape into a global one. The functional changes were the decrease of EF and alteration of LV working performance, that is, from the LV ejection predominantly due to constraction of the middle circle and the longitudinal axis to that predominantly due to constraction of the bottom circle.The multiple variable regression analysis demonstrated that the diameter of the papillary level ring is an important parameter for stroke volume and LV volume. The discriminant functions which were set up at two critical levels are of practical significance.